Table 2_Global trends and regional disparities in the burden of headache disorders, 1990–2021: a comprehensive analysis of the global burden of disease study.docx

BackgroundHeadache disorders significantly impact health and functioning, yet studies on their global burden across all age groups are limited. This study utilizes data from the Global Burden of Disease (GBD) 2021 to investigate the global burden of headache disorders.
MethodsThis analysis draws on GBD 2021 data, covering 204 countries and territories. We investigated the prevalence, incidence, and DALYs for headache disorders from 1990 to 2021, calculating Estimated Annual Percentage Change (EAPC) to analyze temporal trends. Additionally, decomposition analysis was used to evaluate the contributions of aging, population growth, and epidemiological changes. The slope index of inequality and concentration index were employed to assess inequalities in disease burden.
ResultsFrom 1990 to 2021, the global prevalence of headache disorders increased significantly, reaching approximately 2.81 billion cases in 2021, a 57.16% increase from approximately 1.79 billion cases in 1990. During this period, the global Age-Standardized Prevalence Rate (ASPR) and Age-Standardized DALY Rate (ASDR) both showed gradual increases, while the Age-Standardized Incidence Rate (ASIR) remained stable, with EAPC values of 0.01, 0.04 and-0.0002, respectively. High Socio-demographic Index (SDI) regions exhibited the highest rates of ASPR, ASIR, and ASDR, whereas Middle SDI regions experienced the fastest growth, with EAPC values of 0.17, 0.17, and 0.18, respectively. The SDI exhibited significant positive correlations with the EAPC of ASPR (R = 0.18, p = 0.0093) and ASIR (R = 0.16, p = 0.027). Decomposition analysis identified population growth as the primary driver in regions with increasing disease burden. The slope index of inequality (SII) shows that disparities in ASPR, ASIR, and ASDR slightly increased from 7,648.13, 2,506.76, and 88.45 in 1990 to 7,851.55, 2,557.94, and 100.38 in 2021. In contrast, the concentration index (CI) in 2021 were 0.05, 0.05, and 0.04, showing no significant change from 1990.
ConclusionHeadache disorders continue to impose a growing burden globally, with marked regional and socio-economic disparities. Addressing these trends requires targeted public health interventions, particularly in high-burden and low-resource settings.

背景：头痛障碍对健康与功能状态造成显著负面影响，但针对全年龄组人群头痛障碍全球疾病负担的相关研究仍较为有限。本研究借助2021年全球疾病负担（Global Burden of Disease, GBD）研究数据，对头痛障碍的全球疾病负担展开分析。
方法：本分析采用覆盖204个国家及地区的GBD 2021数据集。研究纳入1990年至2021年头痛障碍的患病率、发病率与伤残调整寿命年（disability-adjusted life years, DALYs）数据，通过计算估计年度变化百分比（Estimated Annual Percentage Change, EAPC）分析时间变化趋势；同时采用因素分解分析，评估人口老龄化、人口增长与流行病学特征变化对疾病负担的贡献占比；并借助不平等斜率指数（slope index of inequality, SII）与集中指数（concentration index, CI），评估疾病负担的人群不平等性。
结果：1990年至2021年，全球头痛障碍患病率显著上升，2021年患病人数约达28.1亿例，较1990年的约17.9亿例增长57.16%。研究期内，全球年龄标化患病率（Age-Standardized Prevalence Rate, ASPR）与年龄标化伤残调整寿命年率（Age-Standardized DALY Rate, ASDR）均呈逐步上升趋势，而年龄标化发病率（Age-Standardized Incidence Rate, ASIR）保持稳定，三者对应的EAPC值分别为0.01、0.04与-0.0002。高社会人口学指数（Socio-demographic Index, SDI）地区的ASPR、ASIR与ASDR水平均为最高，而中SDI地区的各项指标增长最快，对应EAPC值分别为0.17、0.17与0.18。SDI与ASPR（R=0.18，P=0.0093）、ASIR（R=0.16，P=0.027）的EAPC呈显著正相关。因素分解分析结果显示，人口增长是疾病负担上升地区的主要驱动因素。不平等斜率指数（SII）结果表明，ASPR、ASIR与ASDR的人群差异从1990年的7648.13、2506.76与88.45小幅升至2021年的7851.55、2557.94与100.38。与之相对，2021年的集中指数（CI）分别为0.05、0.05与0.04，较1990年无显著变化。
结论：头痛障碍在全球范围内的疾病负担仍持续加重，且存在显著的地区与社会经济差异。应对这一趋势需要制定针对性的公共卫生干预策略，尤其应优先关注疾病负担较高且资源匮乏的地区。